Health and Care Bill

Debate between Lord Bishop of Carlisle and Lord Carlile of Berriew

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[The Lord Bishop of Carlisle]

My Lords, I recognise and respect the integrity and passion that underlie Amendment 297. However, I rise to agree wholeheartedly and briefly with those noble Lords and noble and learned Lords who have already expressed their significant reservations about it.

There are two problems in particular with that amendment. The first has to do with the many contentious arguments for and against any legislation permitting assisted dying, some of which have already been mentioned. Tempting though it is to rehearse some more of those, I am conscious not only of the time but of the fact that they have already been presented recently and at length, as we have been reminded by the noble and learned Lord, Lord Mackay, at Second Reading of the Assisted Dying Bill here in your Lordships’ House. The ongoing process of that Bill, however slow it may be, should not be undermined. We have also been assured that this is not primarily what Amendment 297 is all about. I might add that the terminology of that amendment is unhelpfully vague. “Vague” is a word that has already been used more than once in the debate today. For instance, we might ask exactly what is meant by “terminally ill” or “medical assistance”.

The second problem, which has already been persuasively argued, concerns the attempted use of this Health and Care Bill potentially, if not directly, to change the law on assisted dying. The proper place for any amendment of this kind should be Committee on the Assisted Dying Bill, not Committee on this Bill, which would be subverted were this amendment to be accepted.

With regard to Amendment 203 in this group, whether or not it is deliberately linked, it is evidently concerned to address the holistic needs of those approaching the end of their lives, and that includes, of course, talking about death. That is something that we would all wish to encourage. However, there is again an issue of vagueness in the amendment, as in Amendment 297. For example,

“wishes and preferences for the end of their life”

could include almost anything, from repeated albeit futile chemotherapy, through bucket list wishes, to assisted suicide. Who decides, and how, that someone lacks capacity for engaging in a conversation about their holistic needs? Who is a “relevant person”, as we have just been reminded by the noble Baroness, Lady Finlay? Then, in proposed new paragraph (c), what does

“having regard to the needs and preferences recorded in such conversations”

actually entail?

Most of what is proposed in the amendment is already covered in End of Life Care for Adults: Service Delivery, NICE guideline NG142, which was published on 16 October 2019. Perhaps it would be simpler just to require healthcare professionals to meet the requirements of that guideline, which would address the heart of the amendment’s stated, and laudable, objective.

[Lord Carlile of Berriew (CB)]

My Lords, it is a real pleasure to follow the right reverend Prelate and, given the similarity between his see and my name, I hope I may be able to slipstream some of his authority.

I entirely agree with the noble and learned Lord, Lord Mackay of Clashfern, and the noble Lord, Lord Moylan, that this is not a debate in which we should be having Second Reading discussions about the principle of assisted dying, and I shall absolutely not do so.

I start by saying a few words about Amendment 203. I was greatly relieved when my noble friend Lady Meacher immediately revealed it to be only a probing amendment, because I had taken the trouble of reading proposed new paragraph (b). This is not the occasion for me to indulge or deploy my inner Rumpole or Henry Cecil by telling your Lordships stories of frauds committed on families by greedy relatives and the like—although there are many to be found in the annals of the criminal courts, even from the time when I practised in north Wales. However, the words “another relevant person” are an absolute recipe for undue influence and ostensible but completely fraudulent carers. I am very surprised that my noble friend, for whom I have enormous respect, thought it right to present such a vague piece of drafting to the House on this occasion.

I am very concerned in relation to both Amendment 203 and Amendment 297 about parliamentary procedure and statutory integrity. I have huge regard for the noble Lord, Lord Forsyth, who is one of our very greatest debaters in this House, and so I listened to him with great care. It has been an unusual occasion to hear him relying on a Liberal Democrat Peer in Scotland and the Scottish Parliament. I am not sure that I have heard him deploy that juxtaposition before—and I am pleased to see that he sees the funny side of that himself. However, I beg him, before Report, to consider whether he has got his concept right or wrong, for I would say that, conceptually, what he proposes is wrong.

I do not want to repeat what was said so clearly by the noble and learned Lord, Lord Mackay, and the noble Lord, Lord Moylan—it does not need to be repeated, and I would diminish it if I tried to—but there are a couple of points to add. One was alluded to very graphically by the noble Lord, Lord Moylan. If, as a rule, one could table an amendment simply saying that the Government—or anyone else, for that matter, as the noble Lord suggested—should present a draft Bill to Parliament, it would be impossible to control. Reference was made to the 200 amendments tabled to the absolutely extant Bill of the noble Baroness, Lady Meacher—it is a living Bill and it can still be debated. It is extremely unfair to suggest, as one noble Baroness did, that those were wrecking amendments. Some of them may be, but the great majority of them are substantive amendments seeking to safeguard vulnerable people. That is one of the things that the private Members’ procedure is for. When a private Member presents a Bill to Parliament—and many have passed; it is not a futile gesture—it has to withstand the same parliamentary scrutiny that we give to the Government when they present Bills before Parliament, such as the police Bill, debates on which a number of us here have been taking part in recently.

Furthermore, let us suppose that the clause from the noble Lord, Lord Forsyth, was passed and that within the 12 months that followed the Government decided not to present a draft Bill to Parliament. I do not believe—though I may be disabused of this by greater judicial minds than mine—that the court would have the power, other than possibly to advise, to order the Government to present such a Bill to Parliament, because that would be a breach of the separation of powers. I do not believe that any judge, other than in a nightmare, would see themselves doing that.